Diabetes Health

Better Screening and Approach to Type 2 Diabetes Needed

Experts say the key to preventing and managing type 2 diabetes is regular glycemia screening, early identification of patients at metabolic risk, and early intervention.

A new consensus statement, published in the Journal of Clinical Endocrinology & Metabolism, supports this approach.

The Endocrine Society journal report says it wants to increase awareness that beta-cell failure occurs much earlier and more severely than commonly believed.

Beta cells are specialized cells in the pancreas that produce insulin.

Team concludes a need for early intervention

The statement is based on the findings of a working group of basic researchers, clinical endocrinologists, and primary care physicians.

They were asked to consider whether current knowledge regarding pancreatic beta-cell defects justifies retargeting and retiming treatment for diabetes in clinical practice.

"There is widespread evidence that conventional approaches to the management of type 2 diabetes have been inadequate," says Jack L. Leahy, M.D., of the Vermont Regional Diabetes Center and one of the authors of the consensus statement.

"Studies have increasingly shown that beta cells have an important role in the progression of diabetes, and if we could gain a better understanding of that role, we may be able to develop new and effective means of treatment,” he says.

Dr. Leahy says that the working group members advocate for continued basic research to better understand beta-cell failure in type 2 diabetes.

Evidence from both human and animal studies suggests that problems arise with in type 2 diabetes with beta cells that cannot adapt insulin secretion to compensate for increasing insulin resistance.

Beta-cell failure is believed to occur at an early stage in the progression of diabetes, and growing evidence suggests that the decline in beta-cell function may be slowed or even reversed, especially if addressed early.

Educating doctors is key

The working group also recommends that pathophysiology-based clinical practices have access to more education. The Society launched a new website, BetaCellsinDiabetes.org, to help inform people.

"It is our hope that the new site will aid primary care physicians in the interpretation of concepts of disease pathogenesis, such as beta-cell dysfunction," Dr. Leahy says. He would like it to “improve medical decision-making regarding treatment of type 2 diabetes.”

In the statement, experts also recommend more studies to build awareness for the clinical value of pharmacological therapies targeting beta-cell function.

Dr. Leahy says more research is needed to determine whether preserving beta-cell function improves health of people with diabetes.

He emphasizes that regular glycemia screening, early identification of patients at metabolic risk, and prompt and aggressive intervention deserves greater emphasis.

Always talk with your doctor to find out more information.

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December 2010

Understanding Type 2 Diabetes

Type 2 diabetes is a metabolic disorder resulting from the body's inability to make enough insulin or to properly use it.

Without adequate production or utilization of insulin, the body cannot move blood sugar into the cells. It is a chronic disease that has no known cure. It is the most common type of diabetes.

Type 2 diabetes is commonly preceded by prediabetes. In prediabetes, blood glucose levels are higher than normal but not high enough to be defined as diabetes. However, many people with prediabetes develop type 2 diabetes within 10 years, says the National Institute of Diabetes and Digestive and Kidney Diseases. With modest weight loss and moderate physical activity, people with prediabetes can delay or prevent type 2 diabetes.

The following are the most common symptoms of type 2 diabetes. However, each individual may experience symptoms differently.

• Frequent infections that don’t heal easily

• High levels of sugar in the blood when tested

• High levels of sugar in the urine when tested

• Unusual thirst

• Frequent urination

• Extreme hunger but loss of weight

• Blurred vision

• Nausea and vomiting

• Extreme weakness and fatigue

• Irritability and mood changes

• Dry, itchy skin

• Tingling or loss of feeling in the hands or feet

Some people who have type 2 diabetes exhibit no symptoms. Symptoms may be mild and almost unnoticeable, or easy to confuse with signs of aging. Half of all Americans who have diabetes don’t know it.